MEDICARE: MISS MARILYN OLUFUNSHO FARINRE RPH., MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	40431	TX

General Provider Information

NPI Number	:	1598760399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARILYN OLUFUNSHO FARINRE RPH., MBA

Provider Business Mailing Address
First Line	:	17522 CHESTNUT TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-7594
Country	:	US
Telephone Number	:	281-277-2715
Fax Number	:

Provider Business Practice Location Address
First Line	:	LYNDON BAINES GENERAL HOSPITAL PHARMACY
Second Line	:	5656 KELLEY STREET
City	:	HOUSTON
State	:	TX
Zip	:	77026-1967
Country	:	US
Telephone Number	:	713-566-5140
Fax Number	:	713-566-5151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	07/08/2007

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